Evaluating the effect of electrode location on surface EMG amplitude of the m. erector spinae p. longissimus dorsi

Variations in surface electromyography (SEMG) amplitude have been shown to be dependent on the dislocation of recording electrodes. Yet no literature is available about the effect of electrode dislocation on SEMG amplitude of the lower back muscles. In this project, the aim was to determine this effect by investigating changes in the SEMG root mean square (RMS), induced by a well-defined dislocation of the recording electrodes. Bipolar SEMG of the longissimus dorsi (LD) muscles was measured in 16 healthy subjects undertaking five functional tasks (standing, forward flexion, re-extension, unsupported sitting and arm/leg lifting), and for eight of those subjects the experiment was repeated within two weeks. Intra-class correlation coefficients (ICCs) were used to show the reliability of the RMS in relation to electrode dislocation, the repeatability of the tasks, and the test–retest reliability. Results showed that: (1) lateral dislocation causes a significant decrease (18%, p < 0.001) in RMS; (2) longitudinal dislocation does not change the RMS; and (3) the variability caused by electrode dislocation is comparable to the variability caused by repetitions of tasks or by electrode repositioning. Our conclusion is that positioning in the mediolateral direction should be exact to minimize changes in SEMG amplitude due to dislocation. However, precise longitudinal electrode positioning seems to be less critical in experimental setups which measure the SEMG of the lower back muscles.     

The influence of dynamic factors on triaxial net muscular moments at the L5/S1 joint during asymmetrical lifting and lowering.

Asymmetrical lifting and lowering are predominant activities in the workplace. Mechanical causes are suggested for many back injuries and the dynamic conditions within which spine loading occurs are related to spine loading increase. More data on tridimensional biomechanical lumbar spine loading during asymmetrical lifting and lowering are needed. A tridimensional dynamic multisegment model was developed to compute spinal loading for asymmetrical box-handling situations. The tridimensional positions of the anatomical markers were generated by a direct linear transformation algorithm adapted for the processing of data from two real and two virtual views (mirrors). Two force platforms measured the external forces. Five male subjects performed three variations (slow, fast and accelerated) of asymmetric lifting and two variations (slow and fast) of asymmetric lowering. The torsional, extension/flexion and lateral bending net muscular moments at the L5/S1 joint were computed and peak values selected for statistical analysis. For the lifting task, the fast and accelerated conditions showed significant increases over the slow condition for torsion, extension/flexion and lateral-bending moments. The accelerated condition also showed significant increases over the fast condition for extension. A comparison between lifting and lowering tasks showed equivalent loadings for torsion and extension. The moments were compared to average maximal values measured on equivalent male subject populations by isokinetic dynamometry. This showed torsional and extension values of 30 and 83% of the maximal possible subject capacity, respectively. These results demonstrated that dynamic factors do influence the load on the spine and highlighted the influence of both lifting and lowering on the loading of the spine. This suggested that for a more complete analysis of asymmetrical handling, the maximal velocity and acceleration produced during lifting should be included.     

Comparison of erector spinae and hamstring muscle activities and lumbar motion during standing knee flexion in subjects with and without lumbar extension rotation syndrome

The aim of this study was to compare the activity of the erector spinae (ES) and hamstring muscles and the amount and onset of lumbar motion during standing knee flexion between individuals with and without lumbar extension rotation syndrome. Sixteen subjects with lumbar extension rotation syndrome (10 males, 6 females) and 14 healthy subjects (8 males, 6 females) participated in this study. During the standing knee flexion, surface electromyography (EMG) was used to measure muscle activity, and surface EMG electrodes were attached to both the ES and hamstring (medial and lateral) muscles. A three-dimensional motion analysis system was used to measure kinematic data of the lumbar spine. An independent-t test was conducted for the statistical analysis. The group suffering from lumbar extension rotation syndrome exhibited asymmetric muscle activation of the ES and decreased hamstring activity. Additionally, the group with lumbar extension rotation syndrome showed greater and earlier lumbar extension and rotation during standing knee flexion compared to the control group. These data suggest that asymmetric ES muscle activation and a greater amount of and earlier lumbar motion in the sagittal and transverse plane during standing knee flexion may be an important factor contributing to low back pain.     

Verification of predicted specimen-specific natural and implanted patellofemoral kinematics during simulated deep knee bend

Verified computational models represent an efficient method for studying the relationship between articular geometry, soft-tissue constraint, and patellofemoral (PF) mechanics. The current study was performed to evaluate an explicit finite element (FE) modeling approach for predicting PF kinematics in the natural and implanted knee. Experimental three-dimensional kinematic data were collected on four healthy cadaver specimens in their natural state and after total knee replacement in the Kansas knee simulator during a simulated deep knee bend activity. Specimen-specific FE models were created from medical images and CAD implant geometry, and included soft-tissue structures representing medial–lateral PF ligaments and the quadriceps tendon. Measured quadriceps loads and prescribed tibiofemoral kinematics were used to predict dynamic kinematics of an isolated PF joint between 10° and 110° femoral flexion. Model sensitivity analyses were performed to determine the effect of rigid or deformable patellar representations and perturbed PF ligament mechanical properties (pre-tension and stiffness) on model predictions and computational efficiency.Predicted PF kinematics from the deformable analyses showed average root mean square (RMS) differences for the natural and implanted states of less than 3.1° and 1.7 mm for all rotations and translations. Kinematic predictions with rigid bodies increased average RMS values slightly to 3.7° and 1.9 mm with a five-fold decrease in computational time. Two-fold increases and decreases in PF ligament initial strain and linear stiffness were found to most adversely affect kinematic predictions for flexion, internal–external tilt and inferior–superior translation in both natural and implanted states. The verified models could be used to further investigate the effects of component alignment or soft-tissue variability on natural and implant PF mechanics.     

Effects of Visual Cues of Object Density on Perception and Anticipatory Control of Dexterous Manipulation

Anticipatory force planning during grasping is based on visual cues about the object’s physical properties and sensorimotor memories of previous actions with grasped objects. Vision can be used to estimate object mass based on the object size to identify and recall sensorimotor memories of previously manipulated objects. It is not known whether subjects can use density cues to identify the object’s center of mass (CM) and create compensatory moments in an anticipatory fashion during initial object lifts to prevent tilt. We asked subjects (n = 8) to estimate CM location of visually symmetric objects of uniform densities (plastic or brass, symmetric CM) and non-uniform densities (mixture of plastic and brass, asymmetric CM). We then asked whether subjects can use density cues to scale fingertip forces when lifting the visually symmetric objects of uniform and non-uniform densities. Subjects were able to accurately estimate an object’s center of mass based on visual density cues. When the mass distribution was uniform, subjects could scale their fingertip forces in an anticipatory fashion based on the estimation. However, despite their ability to explicitly estimate CM location when object density was non-uniform, subjects were unable to scale their fingertip forces to create a compensatory moment and prevent tilt on initial lifts. Hefting object parts in the hand before the experiment did not affect this ability. This suggests a dichotomy between the ability to accurately identify the object’s CM location for objects with non-uniform density cues and the ability to utilize this information to correctly scale their fingertip forces. These results are discussed in the context of possible neural mechanisms underlying sensorimotor integration linking visual cues and anticipatory control of grasping.     

Accuracy of mobile biplane X-ray imaging in measuring 6-degree-of-freedom patellofemoral kinematics during overground gait

The aim of this study was to evaluate the accuracy with which mobile biplane X-ray imaging can be used to measure patellofemoral kinematics of the intact knee during overground gait. A unique mobile X-ray imaging system tracked and recorded biplane fluoroscopic images of two human cadaver knees during simulated overground walking at a speed of 0.7 m/s. Six-degree-of-freedom patellofemoral kinematics were calculated using a bone volumetric model-based method and the results then compared against those derived from a gold-standard bead-based method. RMS errors for patellar anterior translation, superior translation and lateral shift were 0.19 mm, 0.34 mm and 0.37 mm, respectively. RMS errors for patellar flexion, lateral tilt and lateral rotation were 1.08°, 1.15° and 1.46°, respectively. The maximum RMS error for patellofemoral translations was approximately one-half that reported previously for tibiofemoral translations using the same mobile X-ray imaging system while the maximum RMS error for patellofemoral rotations was nearly two times larger than corresponding errors reported for tibiofemoral rotations. The lower accuracy in measuring patellofemoral rotational motion is likely explained by the symmetric nature of the patellar geometry and the smaller size of the patella compared to the tibia.     

Lifting over an obstacle: effects of one-handed lifting and hand support on trunk kinematics and low back loading

Mechanical loading of the low back during lifting is a common cause of low back pain. In this study two-handed lifting is compared to one-handed lifting (with and without supporting the upper body with the free hand) while lifting over an obstacle. A 3-D linked segment model was combined with an EMG-assisted trunk muscle model to quantify kinematics and joint loads at the L5S1 joint. Peak total net moments (i.e., the net moment effect of all muscles and soft tissue spanning the joint) were found to be 10+/-3% lower in unsupported one-handed lifting compared to two-handed lifting, and 30+/-8% lower in supported compared to unsupported one-handed lifting. L5S1 joint forces also showed reductions, but not of the same magnitude (18+/-8% and 15+/-10%, respectively, for compression forces, and 15+/-17% and 11+/-14% respectively, for shear forces). Those reductions of low back load were mainly caused by a reduction of trunk and load moment arms relative to the L5S1 joint during peak loading, and, in the case of hand support, by a support force of about 250 N. Stretching one leg backward did not further reduce low back load estimates. Furthermore, one-handed lifting caused an 6+/-8 degrees increase in lateral flexion, a 9+/-5 degrees increase in twist and a 6+/-6 degrees decrease in flexion. Support with the free hand caused a small further increase in lumbar twisting. It is concluded that one-handed lifting, especially with hand support, reduces L5S1 loading but increases asymmetry in movements and moments about the lumbar spine.     

Spinal constraint modulates head instantaneous center of rotation and dictates head angular motion

The head is kinematically constrained to the torso through the spine and thus, the spine dictates the amount of output head angular motion expected from an input impact. Here, we investigate the spinal kinematic constraint by analyzing the head instantaneous center of rotation (HICOR) with respect to the torso in head/neck sagittal extension and coronal lateral flexion during mild loads applied to 10 subjects. We found the mean HICOR location was near the C5-C6 intervertebral joint in sagittal extension, and T2-T3 intervertebral joint in coronal lateral flexion. Using the impulse-momentum relationship normalized by subject mass and neck length, we developed a non-dimensional analytical ratio between output angular velocity and input linear impulse as a function of HICOR location. The ratio was 0.65 and 0.50 in sagittal extension and coronal lateral flexion respectively, implying 30% greater angular velocities in sagittal extension given an equivalent impulse. Scaling to subject physiology also predicts larger required impulses given greater subject mass and neck length to achieve equivalent angular velocities, which was observed experimentally. Furthermore, the HICOR has greater motion in sagittal extension than coronal lateral flexion, suggesting the head and spine can be represented with a single inverted pendulum in coronal lateral flexion, but requires a more complex representation in sagittal extension. The upper cervical spine has substantial compliance in sagittal extension, and may be responsible for the complex motion and greater extension angular velocities. In analyzing the HICOR, we can gain intuition regarding the neck’s role in dictating head motion during external loading.     

Is the trunk movement more perturbed after an asymmetric than after a symmetric perturbation during lifting?

Low back injury is associated with sudden movements and loading. Trunk motion after sudden loading depends on the stability of the spine prior to loading and on the trunk muscle activity in response to the loading. Both factors are not axis-symmetric. Therefore, it was hypothesized that the effects on trunk dynamics would be larger after an asymmetric than after a symmetric perturbation. Ten subjects lifted a crate in which, prior to lifting, a mass was displaced to the front or to the side without the subjects being aware of this. Crate and subject movements, crate reaction forces and muscle activity were recorded. From this, the stability prior to the perturbation was estimated, and the trunk angular kinematics and moments at the lumbo-sacral joint were calculated. Both perturbations only minimally affected the trunk kinematics, although the stability of the spine prior to the lifting movement was higher in the sagittal plane than in the frontal plane. In both conditions the stability appeared to be sufficient to absorb the applied perturbation.     

Mathematical and empirical proof of principle for an on-body personal lift augmentation device (PLAD)

In our laboratory, we have developed a prototype of a personal lift augmentation device (PLAD) that can be worn by workers during manual handling tasks involving lifting or lowering or static holding in symmetric and asymmetric postures. Our concept was to develop a human-speed on-body assistive device that would reduce the required lumbar moment by 20-30% without negative consequences on other joints or lifting kinematics. This paper provides mathematical proof using simplified free body diagrams and two-dimensional moment balance equations. Empirical proof is also provided based on lifting trials with nine male subjects who executed sagittal plane lifts using three lifting styles (stoop, squat, free) and three different loads (5, 15, and 25kg) under two conditions (PLAD, No-PLAD). Nine Fastrak sensors and six in-line strap force sensors were used to estimate the reduction of compressive and shear forces on L4/L5 as well as estimate the forces transferred to the shoulders and knees. Depending on lifting technique, the PLAD applied an added 23-36Nm of torque to assist the back muscles during lifting tasks. The peak pelvic girdle contact forces were estimated and their magnitudes ranged from 221.3+/-11.2N for stoop lifting, 324.3+/-17.2N for freestyle lifts to 468.47+/-23.2N for squat lifting. The PLAD was able to reduce the compression and shear forces about 23-29% and 7.9-8.5%, respectively.     

Lumbar muscle electromyographic dynamic topography during flexion-extension

The objective of this study is to introduce dynamic topography of surface electromyography (SEMG) to visualize lumbar muscle myoelectric activity and provides a new view to analyze muscle activity in vivo. A total of 20 healthy male subjects and 15 males LBP were enrolled. An electrode-array was applied to the lumbar region to collect SEMG. The root mean square (RMS) value was calculated for each channel, and then a 160×120 matrix was constructed using a linear cubic spline interpolation of each scan to create a 2-D color topographic image. Along a definite interval of action, a series of RMS topography matrices was concatenated as a function of position and time, to form a dynamic topographical video of lumbar muscle activity. Relative area (RA), relative width (RW), relative height (RH) and Width-to-Height Ratio (W/H) were chosen as the four quantitative parameters in measuring topographic features. Normal RMS dynamic topography was found to have a consistent, symmetric pattern with a high intensity area in the paraspinal area. LBP patients had a different RMS dynamic topography, with an asymmetric, broad, or disorganized distribution. Quantitative SEMG features were found significantly different between normal control and LBP. After physiotherapy rehabilitation, the dynamic topography images of LBP tended towards the normal pattern.There are obvious differences in lumbar muscle coordination between healthy subjects and LBP patients. The dynamic topography allows the continuous visualization of the distribution of surface EMG signals and the coordination of muscular contractions.     

Repression of Rx gene on the left side of the sensory vesicle by Nodal signaling is crucial for right-sided formation of the ocellus photoreceptor in the development of Ciona intestinalis

Nodal signaling plays an essential role in the establishment of left–right asymmetry in various animals. However, it is largely unknown how Nodal signaling is involved in the establishment of the left–right asymmetric morphology. In this study, the role of Nodal signaling in the left–right asymmetric ocellus formation in the ascidian, Ciona intestinalis was dealt with. During the development of C. intestinalis, the ocellus pigment cell forms on the midline and moves to the right side of the midline. Then, the photoreceptor cells form on the right side of the sensory vesicle (SV). Ci-Nodal is expressed on the left side of the SV in the developing tail bud embryo. When Nodal signaling is inhibited, the ocellus pigment cell form but remain on the midline, and expression of marker genes of the ocellus photoreceptor cells is ectopically detected on the left side as well as on the right side of the SV in the larva. Furthermore, Ci-Rx, which is essential for the ocellus differentiation, turns out to be negatively regulated by the Nodal signaling on the left side of the SV, even though it is required for the right-sided photoreceptor formation. These results indicate that Nodal signaling controls the left–right asymmetric ocellus formation in the development of C. intestinalis.     

Effectiveness of the 1RM estimation method based on isometric squat using a back-dynamometer

This study aimed to clarify the relationships between isometric squat (IS) using a back dynamometer and 1 repetition maximum (1RM) squat for maximum force and muscle activities and to examine the effectiveness of a 1RM estimation method based on IS. The subjects were 15 young men with weight training experience (mean age 20.7 ± 0.8 years, mean height 171.3 ± 4.4 cm, mean weight 64.4 ± 8.4 kg). They performed the IS with various stance widths and squat depths. The measured data of exerted maximum force and the action potential of the agonist muscles were compared with the 1RM squat data. The exerted maximum force during IS was significantly larger in wide stance (140% shoulder width) than in narrow stance (5-cm width). The maximum force was significantly larger with decreased knee flexion. As for muscle activity, the % root mean square value of muscle electric potential of the rectus femoris and the vastus lateralis tended to be higher in wide stance. As for exerted maximum force, wide stance and parallel depth in IS showed a significant and high correlation (r = 0.73) with 1RM squat. Simple linear regression analysis revealed a significant estimated regression equation [Y = 0.992X + 30.3 (Y:1RM, X:IS)]. However, the standard error of an estimate value obtained by the regression equation was very large (11.19 kg). In conclusion, IS with wide stance and parallel depth may be useful for the estimation of 1RM squat. However, estimating a 1RM by IS using a back dynamometer may be difficult.     

Classification of large array surface myoelectric potentials from subjects with and without low back pain.

An algorithm was developed and tested for differentiating between the spatial distribution of large arrays of surface electromyographic (LASE) data from subjects with and without low back pain (LBP). The surface EMG data from 62 channels were collected from the low back of 161 healthy and 44 acute (less than 6-weeks) LBP subjects in three minimum stress postural positions including standing, 20 degrees of trunk flexion (at hip joint) and standing with arms extended forward holding a 1.36kg (3lb) weight in each hand. These data were statistically analyzed and the spatial distribution of the root mean square (RMS) values was used in a multivariate quadratic discriminant model to reclassify the healthy and acute LBP subjects. The most predictive results were obtained from the 'flexion' group of experiments and correctly reclassified 95.5% (42/44) of the acute LBP subjects and 99.4% (160/161) of the healthy subjects. The success rate of this reclassification based on surface distribution of myoelectric potentials was found to be better than the reported patient classifications based on a smaller set of electrode pairs using fewer subjects [Peach JP, McGill SM, Classification of low back pain with use of spectral electromyogram parameters. Spine 23(10):1998;1117-23; Roy SH, De Luca CJ, Emley M, Oddsson LI, Buijs RJ, Levins JA, Newcombe DS, Jabre JF. Classification of back muscle impairment based on the surface electromyographic signal. J Rehabil Res Dev 34(4):1997;405-14 [review]]. The results indicated the potential of the model for clinical patient classification.     

An empirical approach to characterizing trunk muscle coactivation using simulation input modeling techniques

Accurately describing trunk muscle coactivation is fundamental to quantifying the spine reaction forces that occur during lifting tasks and has been the focus of a great deal of research in the spine biomechanics literature. One limitation of previous approaches has been a lack of consideration given to the variability in these coactivation strategies. The research presented in this paper is an empirical approach to quantifying and modeling trunk muscle coactivation using simulation input modeling techniques. Electromyographic (EMG) data were collected from 28 human subjects as they performed controlled trunk extension exertions. These exertions included isokinetic (10 and 45°/s) and constant acceleration (50°/s/s) trunk extensions in symmetric and asymmetric (30°) postures at two levels of trunk extension moment (30 and 80 Nm). The EMG data were collected from the right and left pairs of the erector spinae, latissimus dorsi, rectus abdominis, external obliques and internal obliques. Each subject performed nine repetitions of each combination of independent variables. The data collected during these trials were used to develop marginal distributions of trunk muscle activity as well as a 10×10 correlation matrix that described how the muscles cooperated to produce these extension torques. These elements were then combined to generate multivariate distributions describing the coactivation of the trunk musculature. An analysis of these distributions revealed that increases in extension moment, extension velocity and sagittal flexion angle created increases in both the mean and the variance of the distributions of the muscular response, while increases in the rate of trunk extension acceleration decreased both the mean and variance of the distributions of activity across all muscles considered. Increases in trunk asymmetry created a decrease in mean of the ipsi–lateral erector spinae and an increase in the mean of all other muscles considered, but there was little change in the variance of these distributions as a function of asymmetry.     

Effect of electrocardiographic contamination on surface electromyography assessment of back muscles

The purpose of this study was to demonstrate the relative effect of electrocardiography (ECG) on back muscle surface electromyography (SEMG) parameters and their corresponding sensitivity in low back pain (LBP) assessment.Back muscle SEMG activities were recorded from 17 healthy subjects and 18 chronic LBP patients under static postures (straight sitting and upright standing), and dynamic action (flexion–extension). ECG cancellation based on independent component analysis (ICA) method was performed. Root mean square (RMS) and median frequency (MF) of raw and denoised SEMG data were computed respectively. Multiple comparisons were then performed.A consistent trend of change (increased MF and decreased RMS) followed ECG removal was noticed. In particular, in SEMG measurements under static postures, a significant decrease in RMS (p < 0.05) and increase in MF (p < 0.05) were found in all recording muscle groups. Level of corruption by ECG artifacts on SEMG measurements was found to be more serious and prominent in static postures than that in dynamic action. After ECG removal, significant improvements in the ability of SEMG to discriminate LBP patients from healthy subjects were seen in RMS amplitude recorded while standing (p < 0.05) and MF in all measuring conditions (p < 0.05).This study provides a more complete understanding on the relative effect of ECG contamination on back muscles SEMG parameters and LBP assessment.     

Lumbar spine angles and intervertebral disc characteristics with end-range positions in three planes of motion in healthy people using upright MRI

Understanding changes in lumbar spine (LS) angles and intervertebral disc (IVD) behavior in end-range positions in healthy subjects can provide a basis for developing more specific LS models and comparing people with spine pathology. The purposes of this study are to quantify 3D LS angles and changes in IVD characteristics with end-range positions in 3 planes of motion using upright MRI in healthy people, and to determine which intervertebral segments contribute most in each plane of movement. Thirteen people (average age = 24.4 years, range 18–51 years; 9 females; BMI = 22.4 ± 1.8 kg/m²) with no history of low back pain were scanned in an upright MRI in standing, sitting flexion, sitting axial rotation (left, right), prone on elbows, prone extension, and standing lateral bending (left, right). Global and local intervertebral LS angles were measured. Anterior-posterior length of the IVD and location of the nucleus pulposus was measured. For the sagittal plane, lower LS segments contribute most to change in position, and the location of the nucleus pulposus migrated from a more posterior position in sitting flexion to a more anterior position in end-range extension. For lateral bending, the upper LS contributes most to end-range positions. Small degrees of intervertebral rotation (1–2°) across all levels were observed for axial plane positions. There were no systematic changes in IVD characteristics for axial or coronal plane positions.     

A novel method to estimate the stiffness of the equine back

Diagnosis of back problems in equine orthopedics can be a difficult task. The aim of our study was to develop a new method for estimating the stiffness of the equine back in vivo. We measured the activity of the long back muscle at two locations on both sides at thoracic vertebrae T12 and T16 of 15 horses flexing and extending their back at stance using telemetric surface electromyography, while simultaneously recording the motion of the back with a video camera system. Out of these paired data sets we computed a transfer function in the frequency domain and evaluated its capability of capturing the biomechanical behavior. The transfer function was evaluated via correlation between calculated and actual motion resulting in correlation coefficients of 0.89 for lateral flexion and 0.83 for ventral extension at T16 and 0.82 for lateral flexion and 0.83 for ventral extension at T12. The transfer function was fitted to a filter polynomial of second order, and related to the motion equation. By comparison of coefficients we gained an estimate for the stiffness of the back resulting in a mean value of approximately 6100 N/m for lateral flexion and 650 N/m for ventral extension. This new method enables clinicians in equine orthopedics to estimate back stiffness in horses, and it also provides reality grounded values for biomechanical models of the equine back.     

Maximum acceptable weight of lift for side and back lifting

A series of laboratory experiments were conducted to find maximum acceptable weights in front, side, and back lifting. Fifteen college students participated in the experiment. Experimental trials for each type of lifting were conducted for 10 min for each subject at a rate of 4 lifts/min. Psychophysical methodology was used to find the acceptable weight based upon their perceived feeling of stress in the lower back. It was found that subjects are willing to lift the heaviest load using back lifting (average maximum acceptable weight: 41.5 lbs). Front lifting was the close second with 39.4 lbs. Also, there was a significant difference in maximum acceptable weight of lift between side lifting (average maximum acceptable weight: 25.5 lbs) and the other two types of lifting. It was also found that leg strength was a limiting variable for maximum acceptable weight in front lifting. Composite strength and shoulder strength were found to be limiting variables in side lifting. Composite strength was the limiting variable in the back lifting.     

Position sense in the lumbar spine with torso flexion and loading

Proprioception plays an important role in appropriate sensation of spine position, movement, and stability. Previous research has demonstrated that position sense error in the lumbar spine is increased in flexed postures. This study investigated the change in position sense as a function of altered trunk flexion and moment loading independently. Reposition sense of lumbar angle in 17 subjects was assessed. Subjects were trained to assume specified lumbar angles using visual feedback. The ability of the subjects to reproduce this curvature without feedback was then assessed. This procedure was repeated for different torso flexion and moment loading conditions. These measurements demonstrated that position sense error increased significantly with the trunk flexion (40%, p < .05) but did not increase with moment load (p = .13). This increased error with flexion suggests a loss in the ability to appropriately sense and therefore control lumbar posture in flexed tasks. This loss in proprioceptive sense could lead to more variable lifting coordination and a loss in dynamic stability that could increase low back injury risk. This research suggests that it is advisable to avoid work in flexed postures.